Basic Information
| Provider Information | |||||||||
| NPI: | 1609296896 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TRUSZKOWSKI | ||||||||
| FirstName: | PIOTR | ||||||||
| MiddleName: | |||||||||
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| OtherLastName: | TRUSZKOWSKI | ||||||||
| OtherFirstName: | PETER | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4 SOLDIERS FIELD PARK | ||||||||
| Address2: | 4D | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021631708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2246282379 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 75 FRANCIS ST | ||||||||
| Address2: | NEVILLE HOUSE | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021156110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177328070 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2014 | ||||||||
| LastUpdateDate: | 04/26/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.